Feeling of something stuck in throat Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.

Scope

This guidance refers to:

  • Distinguishing between globus pharyngeus and significant throat pathology in adults

This guidance does not cover:

  • Under 18s

Assessment

Signs and Symptoms

Symptoms suggesting benign globus pharyngeus:

  • Noticed at midline or suprasternal notch?
  • Intermittent
  • No true dysphagia

History and Examination

On physical examination does the patient have:

  • Normal oral cavity, head and neck examination
  • No pain
  • Normal voice quality

Red Flags

Seek immediate or urgent specialist advice/treatment

If the patient has any of the following refer as head and neck 2ww:

  • Significant Smoking / Alcohol history
  • Significant referred otalgia
  • Dysphagia
  • Hoarseness
  • Stridor
  • Persistently unilateral symptoms
  • Abnormal neck examination e.g. enlarged nodes

Management

  • Reassure patient, no further intervention
  • Advise the patient to return if they develop any new symptoms
  • Induction dose trial of PPI/ Alginate if oesophageal symptoms, 1 month high dose and 1 month maintenance dose.

Referral

Referral Criteria

  • Red flags
  • If no better in 6 weeks or new symptoms are presented, consider a referral to ENT

Referral Instructions

  • e-consultation is not currently available for this specialty
  • Referrals should be made via ICG to TRISH (if training has been undertaken) - See user guides (EMIS & S1) for further information.
  • For those Practices who have not received ICG training referrals should be made via eRS
  • Please identify speciality and clinic type

Supporting Information

Shared Decision Making

  • Patients have a right to make decisions about their care and should be fully informed about the options they face. They should be provided with reliable evidence-based information on the likely benefits and harms of interventions or actions, including any uncertainties and risks, eliciting their preferences and supporting implementation.

Patient information/Public Health/Self Care

Assurance & Governance

  • This guidance was developed on: 05.2017
  • This Care Pathway was ratified by: The OSCAR Assurance Group
  • Date ratified: 05.2017
  • Publication Date: 05.2017
  • Review Date: 05.2019
  • Ref No: ENT1 - 05.2017
Any feedback or suggestions to improve this guidance should be sent to: oscaradmin@this.nhs.uk
Only the electronic version is maintained, once printed this is no longer a controlled document

 

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